HomeMy WebLinkAbout14449-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z-16713 Date March 16, 1988
THIS CERTIFIES that tile building CONSTRUCT ADDITION & ALTERATION
Location of Property 250 Blue Marlin Drive Greenport, N.Y.
Hou$o IVo, Street Ham/et
County Tax Map No. 1000 Section 05 6 .. ,Block 0 7 ,Lot 0 2 I
Subdivision..M./9..Sg,u,~h. 91..d. ,Sh. 9.re. ,s ........... Filed Map No...3.8.5.3...Lot No, , .3 ...........
conforms substantially to the Application for Bnilding Permit heretofore filed in this office dated
.... .N.o.v.e.m..b.e.r.. 6.:,. I. 9. 8 5 pursuant to which Building Permit No... 1.4..4.4,9.. z. ...........
dated .... ,D .e.c.e,m. b..e,r.. 5. ~. ,1.9. 8..5 ..... was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .........
ADDITIONS & ALTERATIONS TO EXISTING ONE FAMILY DWELLING
The certificate is issued to HOWARD & JANET A. MALONE
..................... ?oY.;;,'l~g~,~'~ .....................
of the aforesaid building.
Suffolk County Department of Health Approval ........ N / A
UNDERWRITERS CERTIFICATE NO .................. ~.8.4. 9. 4..2.7..-~..J.a.n.....1.1. ,.. } .9.8.8. ....
March 15, 1988
PLUMBERS CERTIFICATION DATED:
Rev. 1/81
·ORM NO. B
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N9 14449 Z
........................................................ , 19o .
Permission is hereby gronted to:
...~'-~ ~.~.~.~,~.~.~C~.......--.....~J..~=....
to .............................................................................. .'~..~.~ ~:~,...;D...../..~ ....... , ...................................
.,.~.~~.'~'...~,~...~.....~ .....................................................................................................
et ;remises I~ated at ...... .~..~~...~,~.$~.L~...:~.{~.~ ..........
...................................................................................................... ~~~~:.~.V.
......... .........
~.~ T.~ ~ No~ ~000 s.~t~o. ~.~.~ ....... ~ ..~..~ ......... L~ No..~.~ .........
pu,uant to application dat~ ~~...~....., i~d approv~ by the
Building Inspector.
Rev. 6/30/80
FORM NO, 6
TOWN OF $OUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted m ~ to the Building Inspec-
__tor with the following; for new buildings or new use:
1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual
natural or topographic features.
2.Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal).
3.Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building.
5.Submit Planning Board approval of completed site plan requirements where applicable.
For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existi~g"
land uses:
1. Accurate survey of pzmperty showing all propertv lines, streets, buildings and unusual natural or
topographic features.
2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees: Additions $25.00 POOLS $25.00
1. Certificateofpccupancy New Dwelling $25.00, Accessory '$]0.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00
4.Vacant Land C.O. $ 20.00
5.Upda-~ed C.O." $ 50.00 Date .?..~../.?..7..~..~. ..........
New C on s t ~ u c t J on ...... Old or Pre-existing Building ....... ,~ .... Vacant Land .............
· _ .
House No. Street Hamlet
Owner or Owners of Property ............................
Z¢. Y n ..........................
County Tax Map No. 1000 Section .... P .~...~. ..... Brock ..... ~ ........ Lot... ?-..1[ ..........
.Filed Map No
Subdivision ~
Health Dept. Approval ................ ' ........ Labor Dept. Approval ........................
Underwriters Approval .: ...................... Planning Board Approval ......................
Fee Submitted $. ~ ¢~-:-~q ·
Con stru ct ion o. above described building and~ ~r_m it meets ~:?cable codes a nd regulations.
App,,ca.t .-. ...................
Rev. 1040-78
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
CERTIFICATION
Date
Building Permit No. I ~4 ~'
(please print)
Plumber ~'~[~ ~
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(plumber's signature)
Sworn to before me this
1,5'{~ day of ~a~'~_ ,'
19 ~
Notary Public,~:l~_~County
No-[~ry Ph-~l ic
DONNA LYNN SPAIN
NOTARY PUBLIC, State of New York
No. :4889145
Qualified in Suffolk County
Commission I?xpires April 6,
TOWN OF SOUTIIOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTIIOLD, N.Y. 11971
TEL. '/65-1802
To Whom This May Concern,
We are unable to complete your Certificate
of Occupancy because .of the following reasons.
/~/ An application for Certificate of Occupancy
is not on file.
/5/ No Underwriters Certificate on file.
/5/ The check is(outdated/not on file.)
/~/ No Health Dept. Approval on file.
/5/ No final inspection has been made.
Please contact our
Thank you for your cooperation.
Building Permit I, __/ ~___ d ~ .~ Z
Building Dept.
***~ No Plumber solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
office on this matter.
TOWN OF SOUTIIOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 723
TOWN HALL
SOUTIIOLD, N.Y. 11971
TEL. 755-1802
To Whom This May Concern,
We are unable to complete your Certificate
of Occupancy because .of the following reasons.
/~/ An application for Certificate of Occupancy
is not on file.
/~/ No Underwriters Certificate on file.
/5/ The check is(outdated/not ou file.)
No Health Dept. Approval on file.
/~/ No final inspection has been made.
Please contact our office on this matter.
Thank you for your cooperation.
~uilding Permit tl ~/ ~. ~ ~ ....~ Z
Building Dept.
No Plumber Soldor Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
THE NEW YORK BOARD OF FIRE .UNDERWRITERS
BUREAU OF ELECTRICITY
JOHN STREET, NEW YORK, NEW YORK 10038
THIS CERTIFIES THAT P#14449E
only the electrical equipment ag d~scribed below and i~troduced by the applicant named on the above application number in
tfoa~d F. Malone. 250 t~lue Marl£n
t~w*s ex. mined on D¢-~celilbel' 28, 1987 a~d found to be in cotnpli..¢e u'ith the req~*iremer~ts of this Board.
FIXTURE FIXTURES RANGES OVENS DISH
OUTLETS
:1.9 62 38
DRYERS FURNACE
19
FUTURE APPLIANCE FEEDERS
TIMECLOCKS UNIT HEATER~ MULTI-OUTLET
SYSTEMS
NO, OF FEET
- DIMMERS
SERVICE DISCONNECT
OTHER APPAEATUS:
S E R V I C E
A, WG
OF CC, COND
OF NEUTRAL
Moward F. M~lone
293 ~lue Marl~m Dr.
Greenport-Southold Shores,
11971
GENERAL MANAGER
8oard
if
[espectors
This certificate must not be altered in any manner; return to the office of incqrrect.'
may
be
identified
by
their
credentials.
FI E~L~ INSPECTION~ )ATE COMMENTS
FOUNDATION (lsfi) ~ ~
FOUNDATION (2nd) ' ...... --
INSULATION PER N.~ '
STATE ENERGY
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [~FINAL
REMARKS:
7GS-~.802
BUILDING DEPT.
INSPECTION
~4~ FOUNDATION IST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING i* ] FINAL
DATE INSPECTOR
7G5-'~802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[~RAMING [ ] FINAL
DATE ~.~/~:~
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION ZST
FOUNDATION ZND [ ] INSULATION
[ ] FINAL
[ ] FRAMING
REMARKS:
[ ]~ROUGH PLBG.
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST
FOUNDATION 2ND [,~NSULATION
[ ] FRAMING
REMARKS:
ROUGH PLBG.
FINAL
DATE
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST
FOUNDATION 2ND
FRAMING
[ ] ROUGH PLBG.
[ ] INSULATION
,r./~FI NAL
REMARKS:
DATE INSPECTOR
250 Blue"Marlin Driv~
Southold, NY 11971
June 2, 1987
Town of Southold
Building Inspector
Town Hall
Main Road
Southold, NY i1971
Attn: Mr. C. Horton
Dear Sir:
Per our discussion of Monday, June 1, this is my letter of
request for a six month extension of the subject building
permit. This will enable me to complete the final phase
of construction on my residence addition.
Thanks very much for your cooperation in this matter.
Yours truly, ~
Howard F. Malone
(Owner/Builder
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
COUTHOLD, N.Y. 11971
TEL.: 765-180:2
TOWN OF SOUTHOLD
Examined~...~..., 19~:'t~--
Approved .SF~.. '~ ...... 19~..~ermit No..[..~..%/..~. ~ ~
Disapproved a/c ----~'-- ...............
APPLICATION FOR BUILDING PERMIT
Received ........... ,19...
Date . .~'..~?.¢~.0.~.£. · · b..., 19 g~"
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necess94ry inspections~,~=~%, ,~. ~ _
(Signature of applicant, or name, if a corporation)
~.'s'~ ~.o,_-" ht~rec.;~ Del& oS'oo.~,~,a.~ ~,/~. m?j
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
~,me of ow=r of premises .I.q. .~? ~ ~ .~. . .~'. . .¢. . . .T.O~. .~'.':. .t~'. . ~.~Z:. e.O. .F. ......................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
....~..~.~.:...~.oir.... h.¢. .°>. 7. '
(Name and title of corporate officer)
Plumber s License No ..........
Electrician's License No. ...... 5//. ~ ......
Other Trade's License No ......................
1. Location of land on which proposed work will be done ............. ~..r'~ .t~.~.~>.. )..~..~ . I. [ .~ .~.~2. ....
;Z~o FSco~: /~-~,o ~re~Ve-~'oo~,,~ ~ .... .~..~..~.
House Number Street Hamlet
County Tax Map No. 1000 Section O
Subdivision 0 7/'/:0l..)) Filed Map No. Lot
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed donstruction:
a. Existing use and occupancy ...[.
b. Intended use and occupancy ............ .9:....z~...-.:. .... ,~,W,~... ~ ....................
3. Nature of work (check which applicable): New Building .......... Addmon ...... Alteration ..........
Repair .............. Removal .............. Demolition ........... i' Other Work ...............
'i't, (Desc ption
4. Estimated Cos ..... / ................... :-' ........... Fee ...... ~ .........................
x (to be p~id on filing this application)
5. If dwelling, number of dwelling units ...... { ..... '... Number of dwelling ~its bn each floor ................
If garage, number of c~s ............................................. ¢ ..........................
6. If business, commercial or mixed occupancy, specify nature and extent of each ~ypej of use ............ > ........
7. D~ensions of/existing structures, if any: Front... ~.q ~6.~ .... Rear . .~ O. ~.~.~ .... Depth .. ~. E ...
Height . .I.~ ........... Number of Sto~es ...... ] .............. ; ' '2 ..... .............. v' · '~
D~ensmns of same structure w~th alterations or additions: Front .~0. :6. ...... ' ....Rear .. ~q.~ ........
~ 5~ / HeiSt [ ~ ~ Number of S~ofies
Depth .............................................................
8. D~mens~onsofentirenewconstmctlon:Fron.... .......... Rear . . .. ..,......De .. .. ........
Height .. ~6.( ........ ~mber of Sto~es ...~.. ........ ~ .............. ~ ................
10. Date of Purchase ............. I.~6~ ........... Name of Fomer Owner .~
11. Zone or use district in which premises are situated . ~ .( ......... ~?~[~& ..................
12. Does proposed construction violate any zoning law, ordinance or regulation: .. ~.Q ...........................
13. Will lot be regraded ...... ~ .................. Will excess fill be removed
Nme of Architect ....... ~ ' . Address .. ~qq.qtte¢~ N~ Pho~
Nmue of Contractor . ., Address ....... 2 (, [ .... ' Phone No' ..... '
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indJ
proper~y lines. Give street and block number or description according to deed, and show
interior or corner lot.
STATE OF NEW YORK,
COUNTY OF ............ ...,. S.S
:ate all set-back dimensions from
street names and indicate whether
I
I [or A
being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract).
above nanled.
He is the .............................................................. i ...........................
(Contractor, agent, corporate officer, etc.)l
of said owner or owners, and is duly authorized to perform or have performed the s~id work and to make and file this
application; that all statements contained in this application are true to the best of his! knowledge and belief; and that the
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
............ ~...2~....,...day of .... .~...t~. ........... , 19 ~...~
~Iotary Public ....... ~....A~.-.. ?..~. ~..a~.. .... County
HELEN IL t)E VOE
NOIAJW PUBLIC. State of New
. Ho...4707878, Suffolk
lerm ~phes Min)h $0. lg~Z.~,
($igfiathi'~ ~dfiapiiii¢~t )
,l
Ng'~l COltlSTAUCTIOM
I I I I
...... .~_ _1__ z_. _I____L,
T/ON'
L
.?.Y., lO - 16"0. C
I
LOW ~
~OTIFY BOILD[NG DEPARTMENT AT
~I~G INSPE~[ONS:
~ ~OU~H - FRAMrNG & PLUM~ING
~E ~[QUtREMENTS OF THE N.Y.
il! ~ Ill
WEST
NE~I
CON STR, OC T iO IV'
~ tl '1
I I I I I
~Ou1'll £L£Vb~TfOK-
//50*
PORCH Roof
,~ lo -/6'~0, C.
/~" O, C,
TR/~Z 6
PO[~c# DECK LEVEL
S UPPL Y ~ ~ b ~ 2.M CANNOT
EXCEED 2/10 of 1% LEAD.
It c, [,per ,ublng is used
~ u wraler d]sldbuting
,~ ,,h d:~g sh~ll be
~: h,'pes K er L only
/ ®
m
17"'0"
r
tJo ~ :
T
2,F'-O'
/6:0° ~
T f
3'-10
17' 0"
)¢ TOP oF
2- 8~
UP
ANDER$F~
A IV-3/-22
CX- ~ 35
/: O'
?_
o" +'-L;'
2~10 :T¢ IS ir
h'J
6t 0"
~OTRT~
L
17'0"